Combined intracoronary streptokinase and percutaneous coronary angioplasty for reperfusion of chronic total coronary occlusion

• Published in: Journal of the American College of Cardiology 1984-10, Vol.4 (4), p.820-824
• Main Authors: Ferguson, David W., Kouba, Craig R., Little, Marta M., Osborne, James L., White, Carl W., Michael Kioschos, J.
• Format: Article
• Language: English
• Subjects: Adult; Angina Pectoris - drug therapy; Angina Pectoris - therapy; Angioplasty, Balloon; Biological and medical sciences; Cardiology. Vascular system; Combined Modality Therapy; Coronary Angiography; Coronary Disease - diagnostic imaging; Coronary Disease - drug therapy; Coronary Disease - physiopathology; Coronary Disease - therapy; Coronary heart disease; Coronary Vessels; Electrocardiography; Heart; Humans; Male; Medical sciences; Streptokinase - therapeutic use
• ISSN: 0735-1097; 1558-3597
• DOI: 10.1016/S0735-1097(84)80412-X

In a 40 year old man with a 1 month total occlusion of a dominant right coronary artery, persistent angina despite medical management indicated inadequate coronary collateral supply to the posterolateral myocardium originally supplied by the totally occluded vessel. Initial attempts at reperfusion of the chronically occluded vessel with an angioplasty guide wire and balloon were unsuc-cessful. However, administration of intracoronary streptokinase resulted in partial reperfusion, after which successful wire-guided balloon angioplasty was accomplished. This case illustrates the potential utility of combining a thrombolytic agent with angioplasty in attempting reperfusion for management of selected cases of chronic total coronary artery occlusion.